“I’m not anti-vaccine, I just don’t believe in flu shots.”
They likely get all other available vaccines for themselves and their kids, but for some reason, they skip the flu shot each year.
I’m Not Anti-Vaccine, I Just Don’t Believe in Flu Shots
Are they just anti-flu vaccine? Is that a thing?
Gloria Copeland told her followers that they didn’t need flu vaccinations because Jesus already “redeemed us from the curse of the flu.”
Why don’t they “believe” in flu shots?
Typical answers you might get, if you ask, include:
I never get the flu – since about 5 to 20% of people get the flu each year, it is certainly possible that you never get the flu, especially if you aren’t around many other people that could spread the flu virus to you. But unless you live and work in a bubble, there is a good chance that you will eventually be exposed to someone with the flu, might catch the flu yourself, and will spread it to someone else.
I only get sick when I get a flu shot – flu shots are inactivated and can’t actually give you the flu. Even the live virus nasal mist flu vaccine won’t cause you to have the flu. While flu vaccines can cause mild flu side effects, if you get sick after after a flu shot, it could be that you have another respiratory virus, your flu vaccine didn’t have time to work, or that it wasn’t effective.
Flu shots are too expensive – most insurance plans cover the costs of flu vaccines, but if you don’t have insurance, it is sometimes possible to find free flu shots at a local health clinic, or you could get a flu shot for $24 at Walmart with a GoodRx coupon.
I don’t have time to get a flu shot – do you have time to get sick with the flu? Many doctors now offer regular flu clinics that make it convenient to just come in and get a flu vaccine or if that isn’t possible, you can likely get a flu vaccine at a nearby pharmacy.
Someone on the Internet told me to never get a flu shot because they are poison – if you are avoiding a flu vaccine because you are worried about thimerosal, miscarriages, that they contain a vaginal spermicide, or other misinformation, then you likely aren’t just anti-flu vaccine…
Gloria Copeland told me I didn’t need one – Jesus didn’t give us a flu shot and doesn’t want you to die with the flu, or measles.
I made sure to get my flu shot well before the start of flu season.
You want some time for it to start working, so that you can be sure that you are protected.
So while some folks talk about getting a flu vaccine too early, you do want to make sure that you get it in time to get protection before flu is active in your area. Still, it is never too late to get a flu vaccine. It is better to get a flu vaccine late in the flu season than to skip it all together.
What about younger kids getting their flu vaccine for the first time and who need 2 doses? When do they start getting protection?
“The first dose “primes” the immune system; the second dose provides immune protection.”
Study Looks at Flu Vaccine Dosing in Children
Although they likely have some protection after that first dose, the best protection will begin 10 to 14 days after their second dose.
We sometimes hear that folks are going to skip their yearly flu vaccine because they don’t believe in flu shots, they never get sick, or they think that flu shots don’t work or are dangerous.
Some nurses and doctors are refusing to get a flu shot and have to wear masks at work.
Flu vaccines are safe and have many benefits, even if they aren’t any where near 100% effective.
So are there any legitimate reasons to skip a flu shot?
Of course.
In fact, three very good reasons to skip a flu shot include:
being younger than 6 months of age
having a severe allergic reaction (e.g., anaphylaxis) after a previous dose of flu vaccine or to any component of the flu vaccine
and, uh…
Actually, although folks might have many of bad excuses, there are only two good reasons to skip a flu shot…
So, infants who aren’t old enough to be vaccinated yet, and anyone who has had a life-threatening reaction to a previous dose.
Additional precautions, but not true contraindications, do including having had Guillain-Barré syndrome <6 weeks after a previous dose of influenza vaccine and having a moderate or severe acute illness with or without fever when you are planning to get vaccinated.
Even if you have had a severe reaction to eggs, you can still get a flu shot. Just get it get it in an inpatient or outpatient medical setting (such as a hospital, clinic, health department, or physician’s office), so that you can be supervised by a health care provider who is able to recognize and manage severe allergic reactions.
Are you skipping the flu shot because you never get sick? How lucky do you feel this year? Don’t continue to gamble that you won’t get the flu. Increase your chances of staying well by getting a flu shot, the best way to avoid the flu.
A yearly flu vaccine is the best way to protect yourself and your family against the flu.
But why do you need to get a flu vaccine each and every year?
Why Do You Need to Get a Flu Vaccine Each Year?
Hopefully we will one day have a universal flu vaccine that covers all flu strains and offers longer lasting protection.
Most folks know we don’t have that flu vaccine yet…
“A flu vaccine is needed every season for two reasons. First, the body’s immune response from vaccination declines over time, so an annual vaccine is needed for optimal protection. Second, because flu viruses are constantly changing, the formulation of the flu vaccine is reviewed each year and updated as needed to keep up with changing flu viruses. For the best protection, everyone 6 months and older should get vaccinated annually.”
So because the protection from the flu vaccine wanes or wears off relatively quickly, even if the flu vaccine strains don’t change from one year to the next, you should get a new flu vaccine.
How long does the protection from the flu vaccine last?
“An analysis from the 2011–12 through 2013–14 seasons noted protection ranging from 54% to 67% during days 0 through 180 postvaccination.”
Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 Influenza Season
The flu vaccines takes about two weeks to become effective and should then last for at least six months – long enough to get you through the average flu season.
“A number of observational studies and a post hoc analysis from a randomized controlled trial have reported decreases in vaccine effectiveness (VE) within a single influenza season, with increasing time postvaccination. Waning effects have not been observed consistently across age groups, virus subtypes, and seasons; and observed declines in protection could be at least in part attributable to bias, unmeasured confounding, or the late season emergence of antigenic drift variants that are less well-matched to the vaccine strain. Some studies suggest this occurs to a greater degree with A(H3N2) viruses than with A(H1N1) or B viruses . This effect might also vary with recipient age; in some studies waning was more pronounced among older adults and younger children. Rates of decline in VE have also varied.”
Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 Influenza Season
That means it should last past the peak of the average flu season, which is typically between December and March.
And in most young, healthy people, the protection likely lasts even longer.
Make sure you are vaccinated well before flu season peaks, which since 1982 has occurred as early as October and as late as March, but is most common in February.
Still, there is some concern that the protection from the flu vaccine can wear off during a flu season, especially if you are very young, very old, or have chronic medical problems, and you get your flu vaccine early and you get exposed late – in April or May.
Of course, that’s not a good reason to delay getting a flu vaccine though, as waiting too long might leave you unprotected if flu peaks early, in October or November.
What to Know About Why You Need the Flu Vaccine Every Year
Since the flu vaccine strains can change and protection doesn’t last from season to season, get a flu vaccine each year. It’s the best way to protect yourself and your family against the flu.
How many doses of flu vaccine will your kids under age 9 years need this year?
That’s right, some kids actually need two doses of the flu vaccine to get the best protection – a priming dose and a booster dose.
How Many Doses of Flu Vaccines Do My Kids Need?
You child might need two doses of flu vaccine, separated by at least 4 weeks, if they are 8 years old or younger and:
this is the first year that they are getting a flu vaccine, or
they have not received two or more total doses of flu vaccine before
That second part is a little confusing.
That’s because the two doses do not have to have been in the same season or even in consecutive seasons. As long as a child has had at least 2 or more doses of flu vaccine in the past, then they only need one dose this year.
And even if they have never had a flu vaccine before, kids who are already 9 years old, only get one dose.
“Evidence from several studies indicates that children aged 6 months through 8 years require 2 doses of influenza vaccine administered a minimum of 4 weeks apart during their first season of vaccination for optimal protection”
Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 Influenza Season
Why do they get 2 doses?
“The first dose “primes” the immune system; the second dose provides immune protection.”
Study Looks at Flu Vaccine Dosing in Children
Because studies show that getting 2 doses of flu vaccine like this works best!
Study – Effectiveness of the 2003-2004 influenza vaccine among children 6 months to 8 years of age, with 1 vs 2 doses.
Study – Vaccine effectiveness against laboratory-confirmed influenza in children 6 to 59 months of age during the 2003-2004 and 2004-2005 influenza seasons.
After decades with a single type of flu vaccine – the flu shot – there are now many different kinds of flu vaccines that many of us can choose from. And your choices are not just between the nasal spray flu vaccine vs a flu shot. There are also a lot of different kinds of flu shots available now.
Everyone needs a flu shot. When will you get yours? Photo by Gabriel Saldana (CC BY-SA 2.0)
Having choices is nice.
It would be also be nice to have a little more guidance on what to do with these choices.
It is actually easy to start by asking which one you should get for your kids, as many of these flu vaccine options are only available for adults and seniors.
Flu Vaccine Options
Before you start thinking too long and hard about potential options, keep in mind that you might not have as many options as you think.
“Not all products are likely to be uniformly available in any practice setting or locality. Vaccination should not be delayed in order to obtain a specific product when an appropriate one is already available.”
Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 Influenza Season
Doctors and clinics might not stock multiple brands or types of flu vaccines, so you might have to get whatever flu vaccine that they have available.
“Within these guidelines and approved indications, where more than one type of vaccine is appropriate and available, no preferential recommendation is made for use of any influenza vaccine product over another.”
Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 Influenza Season
And that’s okay. In most cases, there haven’t been head to head studies showing that one flu vaccine is better than another.
Flu Vaccine Options for Kids
Still, since these options might be available to you, it is good to know about them.
This year, younger kids, between the ages of 6 months and 3 years, can either get:
FluLaval Quadrilvalent
Fluarix Quadrivalent
Fluzone Quadrivalent Pediatric
While you are unlikely to notice a difference, both FluLaval and Fluarix are given at a 0.5ml dose containing 15 µg of HA per vaccine virus, while Fluzone is given at a 0.25ml dose containing 7.5 µg of HA per vaccine virus. Why the difference? “Safety and reactogenicity were similar between the two vaccines,” even at the different doses.
Basically, these are just different brands of the same type of flu shot.
There are even more options as your kids get older though, including Fluzone Quadrivalent (age three and above), Afluria Quadrivalent or Trivalent (age five and above), Flucelvax Quadrivalent (age four and above), FluLaval and Fluarix.
Of these, some folks wonder if Flucelvax, since it isn’t made in chicken eggs, might be more effective than the others. Remember, one of the things that are thought to make the flu vaccine less effective than most other vaccines is that they are made in eggs, leading to mutations. And there is actually some evidence that those flu vaccines that are not made in eggs might be more effective.
“And the University of Pittsburgh Medical Center is taking that a step further, saying it will only be buying the two egg-free vaccines on the market: Flucelvax and FluBlok. That’s because there is some evidence these two formulations may work better than the older vaccines grown in eggs, said Dr. Richard Zimmerman, who advises the UPMC Influenza Committee.”
Guidance on which flu vaccine to get: Shots for kids, maybe go egg-free
Again, remember that the CDC has made “no preferential recommendation” for one flu vaccine over another. Why not? We don’t have enough information to make that kind of recommendation.
Should parents only ask for Flucelvax? That would only work if they made enough doses for every kid to get vaccinated, which they didn’t. Should you hold out until you can find FluceIvax for your kids? No, since doing that might leave them unvaccinated once flu season hits.
What else should you know about your flu vaccine options? While over 80% of flu vaccines are now thimerosal free, most of these flu vaccines are still available in multi-dose vials with thimerosal.
Also thimerosal free, this year, Flumist is back as an option. It is available for healthy kids who are at least two years old. Although the AAP has issued a preference for flu shots this year, the ACIP says that kids can get either Flumist or a flu shot.
What about if your kids are allergic to eggs?
“Persons who report having had reactions to egg involving symptoms other than urticaria (hives), such as angioedema, respiratory distress, lightheadedness, or recurrent emesis; or who required epinephrine or another emergency medical intervention, may similarly receive any licensed, recommended, and age-appropriate influenza vaccine (i.e., any IIV, RIV4, or LAIV4) that is otherwise appropriate for their health status.”
Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 Influenza Season
Unless they had a severe allergic reaction to a previous flu vaccine, they can get any available flu vaccine, especially if the previous reaction was only hives or they are able to eat eggs.
What if you want a flu vaccine without aluminum? Take your pick. While it would be safe it was, aluminum is not an ingredient in flu vaccines.
Flu Vaccine Options for Adults
In addition to all of the flu vaccines available for older kids, adults have a few more options:
Afluria Quadrivalent or Trivalent can be given by jet injector to those between the ages of 18 and 64 years
Flublok Quadrivalent – a recombinant flu shot that can be given to those who are at least 18 years old
Fluzone High-Dose – a trivalent flu shot with a higher dose of flu virus antigens (4 times the amount of antigen as a regular flu shot) that is available for seniors who are at least 65 years old
Fluad – a trivalent flu shot with an adjuvant that is available for seniors who are at least 65 years old
Why get a flu vaccine with a jet injector instead of a standard needle? High-pressure jet injectors don’t use needles!
Like FluceIvax, Flublok is not made in chicken eggs. The recombinant hemagglutinin(HA) proteins are made in insect cell lines. Does Flublok work better than egg based flu vaccines? That’s the theory, but again, there is no preference for one of these vaccines over another.
Seniors have even more choices.
Should they get Fluzone High-Dose, Fluad, or one of the other flu vaccines? Both have been shown to be more effective than standard flu vaccines in seniors, but they have not been compared against each other.
“In a Canadian observational study of 282 people aged 65 years and older conducted during the 2011-12 season, Fluad was 63% more effective than regular-dose unadjuvanted flu shots.”
CDC on People 65 Years and Older & Influenza
But neither Fluzone High-Dose nor Fluad are quadrivalent, so only protect against three flu virus strains.
Is there a quadrivalent flu shot for older adults that might work better than standard flu shots?
Yes. FluceIvax and Flublok are non-egg based quadrivalent flu shots that might be more effective than standard flu vaccines.
So are you more confused now that you know you have so many options? Just remember that for most people, the mistake isn’t about choosing the right flu vaccine, it is about not getting vaccinated.
What to Know About Your Flu Vaccine Options
While it might seem like you have a lot more options in a flu vaccine this year and that some might be more effective than others, keep in mind that availability will likely greatly limit these “options.”
And the best flu vaccine is the one that you actually get, as it will be the one that reduces your risk of getting the flu. Missing your chance to get vaccinated and protected because you are waiting for a specific brand or type of flu vaccine isn’t going to help keep the flu away.
Some people still think that getting a flu shot will cause them to have the flu.
Why do some people skip it?
Can Flu Shots Cause the Flu?
Yes, some people think that getting a flu shot will actually cause them to get the flu.
It’s not hard to see why though.
The flu vaccine is not the most effective vaccine we have, so it is certainly possible that you can still get sick with the flu even though you have had your flu vaccine. Of course, that’s not a good reason to skip getting a flu vaccine, as they have lots of benefits.
Some other reasons you might still think that the flu vaccine can cause the flu include that:
side effects after a flu shot can include a soreness, low-grade fever, headache and muscle aches, which some people might confuse with a mild case of the flu
many other respiratory viruses can make you sick during cold and flu season, none of which the flu vaccine protects you against
since the flu vaccine takes about two weeks to work, if you got sick shortly after being vaccinated, you may have already been exposed and developed the flu before the vaccine became effective
But why can’t the flu shot cause the flu?
That’s easy.
It’s because the flu shot is an inactivated vaccine. The influenza virus is killed or inactivated, the viral particles are purified and split up, with only the HA and NA surface glycoproteins remaining. Those glycoproteins can not cause a natural flu infection.
While Flumist is a live virus vaccine, it is made with attenuated or weakened strains of the flu that are cold-adapted, unable to replicate at the warmer temperatures that are found in the lungs and other areas of our bodies.
So Flumist doesn’t cause the flu either.
Hopefully this is one vaccine myth that folks will stop spreading. Remember, flu vaccines don’t cause you to get sick with the flu. Get vaccinated. Flu vaccines are your best protection against the flu.
What about those folks who say that they are going to skip the flu shot because they never get sick with the flu?
They are gambling.
It is estimated that about 5 to 20% of people get the flu each year. Unless you are rarely around other people during flu season, the chances are that you will eventually get the flu, especially if you are unvaccinated and unprotected.
